Correlation Between Brain Atrophy And Cognitive Impairment In Subcortical Ischemic Vascular Disease Patients

BackgroundBrain atrophy(BA)was one of neuroimaging features of subcortical ischemic vascular disease(SIVD).With the rapid aging of population,the prevalence of SIVD increases year by year.Cognitive function impairment is the main clinical symptom of SIVD and brain atrophy.Currently,existing studies have suggested that brain atrophy may be related to cognitive function impairment in patients with SIVD.However,studies on the correlation between brain atrophy and cognitive function in patients with SIVD are still relatively lacking,and the relevant mechanisms remain unclear.Clarifying the correlation between brain atrophy and cognitive impairment in patients with SIVD can provide relevant ideas and clues for clinical research and diagnosis and treatment.ObjectiveThe correlation between brain atrophy and cognitive impairment in patients with SIVD was investigated through statistical analysis of the epidemiological data of patients with SIVD.MethodsA cross-sectional study was used in this study.A total of 802 patients aged 60 years or older with SIVD admitted to the Department of Neurology,the Second Affiliated Hospital of Guangzhou Medical University from October 2018 to June 2022 were collected.Brain atrophy,ischemic white matter lesions,and lacunar infarction were evaluated by experienced neurologists.Cognitive function was assessed using the MiniMental State Examination(MMSE).One-way analysis of variance,Chi-square test,multiple linear regression analysis,logistics regression analysis and structural equation model were used to analyze the data,to explore the correlation between brain atrophy and cognitive impairment in patients with SIVD.Results(1)According to the degree of total brain atrophy,there were 26 cases(3.24%)of total brain atrophy group,259 cases(32.29%)of mild brain atrophy group and 517cases(64.46%)of severe brain atrophy group.Gender,age,history of hypertension,history of cerebral infarction,high density lipoprotein cholesterol,homocysteine,folic acid,uric acid,C-reactive protein,left common carotid artery lumen diameter,right internal carotid artery systolic peak velocity,left internal carotid artery vascular resistance index and right internal carotid artery vascular resistance index in patients with SIVD with different degrees of cerebral atrophy.The difference was statistically significant(P < 0.05).(2)The Age-Related White Matter Change(ARWMC)scores and total ARWMC scores in the frontal,parietal,occipital,temporal,subtential and basal ganglia regions of SIVD patients with different degrees of brain atrophy were statistically significant(P < 0.05).There were statistically significant differences in Lacunar cerebral Infarction(LI)scores and total LI scores in the frontal,parietal,temporal,subtentatal,and basal ganglia of patients with SIVD with different levels of brain atrophy(P < 0.05).(3)In the whole brain,there were statistically significant differences in the cognitive functions of SIVD patients with different degrees of brain atrophy,including orientation,memory,attention and calculation,recall ability,language ability and total score of MMSE(P < 0.05).There were statistically significant differences in the scores of different cognitive abilities and overall cognitive function in SIVD patients with different degrees of brain atrophy in the frontal,parietal,occipital,temporal,subtentorial and basal ganglia regions(P < 0.05).(4)In the results of multiple linear regression analysis,male,older age and higher degree of brain atrophy were associated with increased cognitive impairment in SIVD patients(P < 0.05).logistics regression model analysis found that a history of alcohol consumption and high degree of brain atrophy were correlated with cognitive impairment in SIVD patients(P < 0.05).High degree of brain atrophy was associated with dementia in SIVD patients(P < 0.05).(5)The underlying variable "basic disease index" was introduced to construct the structural equation model of cognitive function of patients with brain atrophy and SIVD.The degree of brain atrophy was negatively correlated with the cognitive function score of patients with SIVD.The more severe the degree of brain atrophy,the lower the cognitive function score,that is,the more serious the cognitive function impairment.Conclusions(1)Brain atrophy is associated with cognitive impairment in patients with SIVD.The greater the degree of brain atrophy,the more severe the cognitive impairment.(2)SIVD patients with brain atrophy in the whole brain and different brain regions(frontal,parietal,temporal,subtentorial,basal ganglia)showed cognitive function decline in the whole cognitive domain,including the overall cognitive ability and different cognitive domains such as orientation,memory,attention and calculation,recall,and language ability.(3)The greater the degree of brain atrophy in SIVD patients,the greater the degree of white matter lesions and lacunar infarction.